The harm caused by the medical profession is called iatrogenesis, and in 1975, Ivan Illich (1926-2002) published Medical Nemesis (republished titled Limits to Medicine) in which he discussed the clinical, social, and cultural iatrogenesis of modern medicine. Illich was a philosopher and social critic of monopolistic institutions and bureaucracies in Western society that undermine self-sufficiency, community, freedom, and dignity.

For Illich, the iatrogenesis of modern medicine is clinical when harm to individuals results specifically from medical treatment. Iatrogenesis is social when medicine as an institution and a bureaucracy creates ill-health by increasing stress; by subverting autonomy and community support; and by depoliticizing sources of illness. And medicine’s iatrogenesis is cultural when its ideology undermines the values that allow individuals to cope with life’s trials and tribulations.

Illich does not discount the beneficial effects of modern medicine. He is clear that, for example, through blood transfusions, surgical techniques, and other treatments, many people who have suffered traumatic physical injuries survive who would not otherwise have survived. However, viewing modern medicine in its clinical-social-cultural entirety, Illich concluded that, on balance, its dehumanizing negative effects outweigh its positive ones.

In narrowing the scope of Illich’s analysis to psychiatry, the iatrogenic balance sheet is far worse. Psychiatry’s clinical iatrogenesis—the physical and psychological harm caused by psychiatric treatment—has been directly experienced by many Mad in America readers, and the social and cultural iatrogenic effects of psychiatry are even more glaring than in the rest of medicine. What follows begins with psychiatry’s clinical iatrogenesis and then covers its social and cultural iatrogenesis.

Clinical Iatrogenesis

In medicine, clinical iatrogenesis comprises all conditions for which physicians and other medical professionals, hospitals and other medical facilities, and their treatments are the causes of various types of harm, including death. This includes not only malpractice, but also includes treatments not considered as violations of medical codes of competence even though the treatment consequences result in damage. In 2000, JAMA reported the US yearly estimated iatrogenic deaths: 12,000 caused by unnecessary surgeries; 27,000 caused by medication errors and other errors in hospitals; 80,000 hospital/healthcare facility acquired infections; and 106,000 “non-error” adverse effects of medication. This totals to 225,000 iatrogenic deaths per year, making it the third leading cause of US death (behind heart disease and cancer); and this 225,000 annual death total does not include iatrogenic non-death injuries.

Still, given modern medicine’s benefits, some of which are life-saving, the clinical effects of non-psychiatry medicine are a mixed bag of positives and negative outcomes. In contrast, psychiatry can point to no treatment that is effective in a scientific sense (in other words, compared to a placebo control or the passage of time). Historically, from bloodletting to contemporary antidepressant drugs, there have always been claims by psychiatry, and even some patients, of treatment effectiveness. However, in all of psychiatry’s bio-chemical-electrical treatments, there is little scientific evidence that any of these treatments are superior to a placebo or the passage of time. Furthermore, all of psychiatry’s bio-chemical-electrical treatments result in serious adverse effects—this even acknowledged by establishment psychiatry.

Antidepressants? In April 2002, JAMA published a randomized controlled trial (RCT) in which the placebo worked better than both the herb St. John’s wort and SSRI Zoloft (a positive “full response” occurred in 32% of the placebo-treated patients, 25% of the Zoloft-treated patients, and 24% of the St. John’s wort-treated patients). Also, in 2002, Irving Kirsch, a leading researcher in the placebo effect, examined 47 drug company studies on various antidepressants (published and unpublished trials), and he discovered that in the majority of the trials, antidepressants failed to outperform placebos; and Kirsch reported that “all antidepressants, including the well-known SSRIs . . . had no clinically significant benefit over a placebo.” Long-term, Psychotherapy and Somatics reported in 2017 (“Poorer Long-Term Outcomes among Persons with Major Depressive Disorder Treated with Medication”) that even after controlling for baseline depression severity, at a nine-year follow-up, antidepressant users had significantly more severe symptoms than those individuals not using antidepressants.

The natural course of depression without any medication? A 2006 National Institute of Mental Health (NIMH) study, “The Naturalistic Course of Major Depression in the Absence of Somatic Therapy,” examined depressed patients who had recovered from an initial episode of depression, then relapsed but did not take any medication following their relapse. One year later, the recovery rate of these non-medicated depressed patients was 85%, which is far higher than the one-year effectiveness for antidepressants.

While antidepressants lack scientific evidence of effectiveness, the iatrogenic effects of SSRIs and other antidepressants are uncontroversial. When trying to reduce or come off antidepressants, 56% of individuals experience withdrawal effects, and approximately one in four people will experience severe withdrawal symptoms. The percentage of sexual dysfunction for SSRI antidepressants runs from 25%–73%, according to a 2010 examination of several studies (in one study of 344 patients who had a history of normal sexual function before SSRI treatments, there was an overall incidence of 58% sexual dysfunction). Furthermore, post-SSRI sexual dysfunction (PSSD), in which sexual dysfunction exists even after discontinuation of the SSRI, was first reported to regulators in 1991. Withdrawal misery, sexual dysfunction, and PSSD are now acknowledged by psychiatry, and antidepressants have also been shown to increase the rate of suicide and violence.

This same negative balance sheet of poor outcomes and serious iatrogenic effects is seen for patients diagnosed with psychosis and treated with antipsychotic drugs. In an NIMH-funded study, Martin Harrow and Thomas Jobe reported in 2007 that at the end of fifteen years, among those patients who had stopped taking antipsychotic drugs, 40% were judged to be in recovery, compared to only 5% in recovery among those who had remained on antipsychotic drugs; and at twenty years, they reported: “While antipsychotics reduce or eliminate flagrant psychosis for most patients with schizophrenia at acute hospitalizations, four years later and continually until the twenty-year follow-ups, patients with schizophrenia not prescribed antipsychotics had significantly better work functioning.” Similar results were found in an RCT done by Lex Wunderink, reported in 2013 in JAMA Psychiatry.

The severe short-term and long-term iatrogenic adverse effects of antipsychotic drugs are uncontroversial. Many Mad in America readers are well acquainted with these adverse effects: from Parkinsonian symptoms of muscle dystonias and akathisia; to large weight gains and diabetes; to neuronal supersensitivity causing psychotic reactions; to brain-structural abnormalities; to reduced life span.

The same negative balance sheets of scientific ineffectiveness and uncontroversial serious short-term and long-term adverse effects exist for all of psychiatry’s bio-chemical-electrical treatments.

Social Iatrogenesis

For Illich, “Medicine undermines health not only through direct aggression against individuals but also through the impact of its social organization on the total milieu.”

Social iatrogenesis includes a medical bureaucracy that renders patients and their families helpless and thereby increases stress, which itself is a prime source of ill-health. Iatrogenesis is social when the institution of medicine subverts autonomy and social supports. Social iatrogenesis also includes depoliticizing sources of sickness, pacifying people so as to not fight against unhealthy societal conditions.

In my clinical practice, the ordeal of medical bureaucracy is one of the top stresses reported. Among these stresses routinely reported are: false-positive diagnostic tests that create extremely stressful anxiety, sometimes for weeks before the bureaucratic machinery provides the correct result; impersonal interactions with medical professionals lacking time and patience; patients feeling captive to uncaring bureaucracies owing to the need for a necessary medication prescription (such as a blood pressure medication); exhausting battles with health insurance carriers; unwanted and coerced treatments; and lost confidence with medical professionals who themselves report to patients being coerced by their bureaucracies to employ diagnostic procedures and treatments that these professionals would not otherwise employ.

It is stressful for all involved in modern medicine. Patients and professionals are dehumanized to become machine cogs to meet the needs of machine medicine, which itself needs be an efficient machine to accommodate the larger societal structure—called the “megamachine” by social critic Lewis Mumford. Patients are dehumanized to become mere broken machines, and physicians, beginning in their sleep-deprived dehumanizing residencies, are socialized to be machine-cog mechanics rather than practitioners of the art of healing. Patients and physicians are made to fit into the machine, alienating them from their humanity. This alienation is of course quite stressful and a source of ill-health.

Modern medicine also depoliticizes sources of illness and thereby pacifies people so as to not fight against unhealthy conditions. Take one issue—the increase in cancer among young people. In 2023, BMJ Oncology reported, “Global incidence of early-onset cancer increased by 79.1% and the number of early-onset cancer deaths increased by 27.7% between 1990 and 2019.” However, rather than people becoming enraged and politically engaged to change carcinogenic environments, an extremely powerful medical-pharmaceutical industrial complex has controlled the societal narrative to focus—not on eliminating environmental-societal causes of cancer—but on expensive cancer treatments. Illich notes:

“People would rebel against such an environment if medicine did not explain their biological disorientation as a defect in their health, rather than as a defect in the way of life which is imposed on them or which they impose on themselves. The assurance of personal political innocence that a diagnosis offers the patient serves as a hygienic mask that justifies further subjection to production and consumption.”

While modern medicine has become increasingly impersonal, bureaucratized, and socially iatrogenic, the essence of psychiatry has long been one of social iatrogenesis.

Psychiatry’s diagnostic manual, the scientifically invalid and unreliable DSM, is an instrument of social iatrogenesis. The DSM manufactures illness from normal human reactions by some individuals in response to some environments. Labeling as medically ill those individuals who are reacting to a dysfunctional family, school, workplace, and societal environment subverts sociopolitical challenges to alienating and dehumanizing environments. DSM diagnoses are also used to categorize individuals as medically ill who themselves are not in distress, but only causing discomfort in others—resulting in those with power in families and society to coerce those without power to submit to treatment.

So, children are labeled with some type of “disruptive behavior disorder,” such as oppositional defiant disorder (ODD), because they refuse to comply with the demands of their school or family; and their rebellion causes discomfort for school and family authorities—resulting in these children being drugged. Illich notes: “Industrial parents, forced to procreate manpower for a world into which nobody fits who has not been crushed and molded by sixteen years of formal education, feel impotent to care personally for their offspring and, in despair, shower them with medicine.”

Similarly, adults experiencing altered states, who themselves may not be in emotional distress but are causing distress for others, are labeled with schizophrenia and other psychoses—and drugged. And among individuals who actually are in emotional distress, psychiatry’s illness categorizations subvert an inquiry into the family, school, workplace, and other societal sources of normal human reactions to alienation and dehumanization—and these individuals are instead simply drugged. Illich notes that social iatrogenesis occurs when an institution:

“. . . serves to legitimize social arrangements into which many people do not fit. It labels the handicapped as unfit and breeds ever new categories of patients. People who are angered, sickened, and impaired by their industrial labor and leisure can escape only into a life under medical supervision and are thereby seduced or disqualified from political struggle for a healthier world.”

Psychiatric diagnoses can be as seductive, addictive, but ultimately as disempowering as heroin. Initially, many individuals report “good feelings” of relief upon hearing an explanation for their malaise (albeit a pseudoscientific explanation), of hope for misery reduction (albeit false hope), and of compassion from others (albeit short-lived). However, these individuals routinely discover that these good feelings are transitory. Illich notes that such diagnostic labels “may protect the patient from punishment only to submit him to interminable instruction, treatment, and discrimination, which are inflicted on him for his professionally presumed benefit.”

Powerlessness and stigma are two such social iatrogenic effects of psychiatry’s diagnostic labels and its biological-genetic explanations. In 2006, Acta Psychiatrica Scandinavica published “Prejudice and Schizophrenia: A Review of the ‘Mental Illness is an Illness Like Any Other’ Approach,” a research review of several studies that compared societal attitudes to labeling someone with a medical illness such as “schizophrenia” versus describing them non-medically as “in crisis.” The researchers found that a belief in biological causality was associated with a more pessimistic view about recovery, and the authors state: “Biogenetic beliefs are related to perceptions of dangerousness and unpredictability, to fear, and to desire for social distance.” Similarly, “Myth: Reframing Mental Illness as a ‘Brain Disease’ Reduces Stigma” (2012), the Canadian Health Services Research Foundation (CHSRF) concluded: “Biological explanations can also instill an ‘us vs. them’ attitude, defining individuals with mental illness as fundamentally different.”

Moreover, if one believes that these conditions are genetically passed on, these diagnoses can stigmatize not only patients but family members, as Illich notes that “. . . diagnosis can defame the patient, and sometimes his children, for life. By attaching irreversible degradation to a person’s identity, it brands him forever with a permanent stigma.”

People who are experiencing emotional and behavioral crises can be helped by others who have patience, curiosity, compassion, and respect—all of which require no special professional training. By medicalizing people’s emotional suffering and behavioral disturbances so that only professionals in a professional environment are sanctioned to treat them, suffering people are deprived of a healing community. And when community members abdicate their helper possibilities, all in the community are deprived of opportunities for growth and bonding.

Cultural Iatrogenesis

Illich explains cultural iatrogenesis:

“It sets in when the medical enterprise saps the will of people to suffer their reality…. Professionally organized medicine has come to function as a domineering moral enterprise that advertises industrial expansion as a war against all suffering. It has thereby undermined the ability of individuals to face their reality, to express their own values, and to accept inevitable and often irremediable pain and impairment, decline and death.”

For Illich, modern medicalization destroys traditional ways of dealing with suffering, sickness, and death, and he saw great cultural harm in which individuals lose their autonomous coping skills, and their communities are weakened.

In the mid-twentieth century, in addition to Illich, there were other prominent thinkers such as Erich Fromm and Lewis Mumford concerned that an increasingly technological, institutionalized, machine-like society was resulting in loss of our humanity. For Mumford, there was a “bribe” occurring in technology-worshipping modernity: for our surrender to an impersonal megamachine, we receive some comforts, conveniences, and even some luxuries, but we lose autonomy, individuality, dignity, community, and love. In a 2021 article, “The Magnificent Bribe,” social critic Zachary Loeb explained: “In denouncing the bribe, Mumford was not simply blasting this or that particular machine. He was questioning the ways that particular machines were used to incorporate people into a much larger technical system.” Mumford was worried that such an incorporation would necessitate people having to become machines at the expense of their humanity.

In non-psychiatry medicine, in return for our acceptance of the idea that sick humans are nothing but broken machines to be fixed by an impersonal mechanic, some patients, at least sometimes, do receive a treatment that extends their lives or actually cures an illness. And so depending on one’s value system, the bribe may be a good deal.

In contrast, in psychiatry, patients receive nothing of scientific value—and often greater suffering in the long-term. Bupkis is the Yiddish word that means absolutely nothing (including nothing of value); and one could title a book about the history of psychiatry as “Bribed with Bupkis.”

How did Illich become a critic of what he would call “cosmopolitan medicine”? He grew up in Europe, and in his twenties came to New York City where he worked for five years as a parish priest in an Irish-Puerto Rican neighborhood; but he became critical of the Roman Catholic Church’s position on several issues, and after being rebuked by the Vatican, he renounced active priesthood. He then lived in Puerto Rico, and traveled widely throughout South America on foot and by bus. He eventually settled in Cuernavaca, Mexico, founding the Centro Intercultural de Documentación, which he called “a center for de-Yankeefication,” aimed at educating clergy and development workers about the negative effects of the imposition of Western values and institutional bureaucracies on traditional communities.

For Illich, modern medicalization destroys traditional ways of dealing with suffering, sickness, and death. Advanced industrial societies and cosmopolitan medicine have redefined “good health.” In traditional societies, Illich observed, good health means enjoying success coping with reality, to be able to feel alive in pleasure and in pain, and to cherish survival but also to risk it. In contrast, “medical civilization” turned “pain into a technical matter, thereby depriving suffering of its inherent personal meanings.” For Illich:

“Traditional cultures confront pain, impairment, and death by interpreting them as challenges soliciting a response from the individual under stress; medical civilization turns them into demands made by individuals on the economy, into problems that can be managed or produced out of existences. Cultures are systems of meanings, cosmopolitan civilization a system of techniques. Culture makes pain tolerable by integrating it into a meaningful setting; cosmopolitan civilization detaches pain from any subjective or intersubjective context in order to annihilate it. Culture makes pain tolerable by interpreting its necessity.”

Through psychiatry’s social iatrogenesis, normal human reactions to individuals’ environment are transformed into illnesses, and through psychiatry’s cultural iatrogenesis, emotional reactions are stripped of meaning, and people are deprived of their autonomous coping skills and supports; and family and community are socialized to believe they lack the training and credentials to be helpful.

Take the example of anxiety, which in cosmopolitan medicalized society is a “symptom” of “mental illness” that requires “treatment” by mental health professionals. In traditional cultures, anxiety has meaning, while psychiatry detaches anxiety from its context in order to annihilate it. In traditional cultures, anxiety is seen as a challenge to an individual’s coping ability, while medicalized civilization turns anxiety into a consumer demand made on the economy for a professional to eliminate. Traditional culture makes anxiety tolerable by interpreting its necessity, while psychiatry actually makes anxiety more intolerable by viewing it as merely a defect to be repaired.

Illich observed that traditional cultures see suffering and death as inevitable; and so to enable these to be borne with dignity, traditional cultures highly value patience, courage, resignation, self-control, perseverance, duty, fascination, compassion, and love. In contrast, in cosmopolitan medicine and cosmopolitan civilization, pain has ceased to be conceived as “natural” and instead:

“It is a social curse, and to stop the ‘masses’ from cursing society when they are pain-stricken, the industrial system delivers them medical pain-killers. Pain thus turns into a demand for more drugs, hospitals, medical services, and other outputs of corporate, impersonal care and into political support for further corporate growth no matter what its human, social, or economic cost. Pain has become a political issue which gives rise to a snowballing demand on the part of anesthesia consumers for artificially induced insensibility, unawareness, and even unconsciousness.”

Seriously depressed moods, suicidality, ego collapses, and bizarre behaviors can often be painful to experience and to observe, but traditional societies, unlike modern cosmopolitan civilization, are not so frightened by these pains that they need to anesthetize them and strip them of meaning. For thinkers such as Illich, Mumford, and Fromm, it is important for us to understand the general context of modern civilization in which psychiatry exists, a context which Illich describes:

“In this context it now seems rational to flee pain rather than to face it, even at the cost of giving up intense aliveness. It seems reasonable to eliminate pain, even at the cost of losing independence. It seems enlightened to deny legitimacy to all nontechnical issues that pain raises, even if this means turning patients into pets. With rising levels of induced insensitivity to pain, the capacity to experience the simple joys and pleasures of life has equally declined. Increasingly stronger stimuli are needed to provide people in an anesthetic society with any sense of being alive. Drugs, violence, and horror turn into increasingly powerful stimuli that can still elicit an experience of self. Widespread anesthesia increases the demand for excitation by noise, speed, violence—no matter how destructive.”

In 1950s through the 1970s, in addition to Illich, Fromm, and Mumford, there were other prominent critics of a bureaucratic societal structure that was not meeting human needs and forcing people to become dehumanized cogs in a machine. In such an era when the megamachine was being seriously challenged, Illich was frustrated by the manner in which some psychiatry critics diverted society from the more fundamental problems of cosmopolitan medicine and the megamachine. Illich believed that psychiatry critics, such as Thomas Szasz, who emphasized the contrast between “unreal” mental illness and “real” physical disease, rendered it more difficult to raise questions about medicalized society in general. Illich concluded that the emphasis of Szasz came at the expense of a more fundamental critique of cosmopolitan medicine and the megamachine societal structure. While Illich agreed with psychiatry critics such as Szasz about the use of “mental illness” for political purposes, for Illich, ideology and politics were at work not only in psychiatry but across the entire field of cosmopolitan medicine.

There is a distinction between psychiatry and non-psychiatry medicine that, with knowledge of treatment outcomes, appears undeniable. The distinction is the nature of the bribe deal. Specifically, in all of the megamachine’s cosmopolitan medicine, we are made to accept the idea that we are machines that get broken and need to be fixed by an impersonal mechanic, and in this “machinizing-dehumanizing,” we lose autonomy, individuality, dignity, community, and love. For our acceptance of our machine-cog role, non-psychiatry medicine provides a mixed-bag clinical return, while from psychiatry, we are bribed with bupkis.

168 COMMENTS

  1. I promise you, Western medicine itself is an iatrogenic disease, psychiatry being a particular virulent form. Nature was the cradle of health for an evolving creature that was preoccupied with physical evolution and survival, and was the only medicine we needed – not an external medicine as we imagine, because for a natural human being the whole of nature they are.

    But we are entering a new age of spiritual consciousness, awakening the alive, creative spiritual energies to self-consciousness and renewed forms of creative self-expression. One of the creative activities of spirit is healing and transformation, and these energies may one day put away the need for medicines once and for all. Perhaps love and life will be it’s own medicine. Perhaps we will evolve beyond the need even for food, and instead feast on sunlight and rainwater. Don’t steel the rainbow from the sky though, and put it on some badge or t-shirt to represent your divisive social identity. The rainbow belongs to the sky, not on a protest flag or a virtue signalling advertisement for sportswear. The rainbow belongs to the sky, and so do you.

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    • https://youtu.be/Ye4cELYLzJM?si=WL6xY7oevg3EWMas

      I have about a year longer to live-all due to psych products. No one in the MH “industry” or the medical “industry” ever since 1989 checked to see if the drugs were having adverse effects on my insides. I recently talked to my surgeon and he is the only one, in all that time, who validated the psych drugs as the causes of my now terminal condition.

      I would like to see MIA devote a whole section solely on ways people can regularly monitor their bodies and minds for all the categories of iatrogenic harm that Mr. Levine mentioned in order to be proactive and realistic: before it’s too late!

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  2. I was a machine-cog in the psychiatric quasi-medicine machine for twenty-two years. Two years after withdrawing from prescribed neurotoxins, I am still suffering from iatrogenic illness: protracted withdrawal syndrome. Thank you, Bruce, for your pertinent article elucidating Illich’s philosophy on the current medical system that continues to antagonize people.

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  3. I don’t understand why actual medical doctors subscribe to psychiatry. Maybe they like to have a place to send patients they don’t like, or patients whose physical problems they can’t figure out.

    At 58 I understand that my life was destroyed by the rise of biological psychiatry and the chemical imbalance theory, the denial of the impact of trauma/lack of agency and environment on a person, the omnipresence of therapy culture, the overwhelming majority of people subscribing to DSM dx like borderline personality disorder and the belief that “mental illness is not only real, it’s a problem in the individual and the public needs to be protected from the mentally ill and cluster B/personality disordered people”, etc.

    I guess it’s good to understand it but unfortunately it’s too late to change anything. They got me young and they got me good.

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  5. Dr. Levine, thank you so much, I love your articles.

    Sometimes I stand like an alien in a doctor’s office and don’t understand what’s going on, I feel like in a foreign world. My dentist’s assistant fights for five minutes in the treatment planning, often not knowing where to find those five minutes, with three screens in front of her, until after 10 minutes she finally says, I need more time to organize and will call you when I find a convenient time for the doctor. I smile and go home being glad not to have to do this job.
    The strict scheduling and short realization of treatment appointments is getting worse and doctors become displeased when time “runs out”.

    I’m watching and waiting to see when the engine of this scam explodes. But I think it will be a while yet.
    I stay away from doctors whenever possible. They enrich themselves from the social insurance funds paid by the people (I’m writing from Germany) in an unbelievable way. Now they are constantly setting up medical care centers where investors are making up to 20% profit……with social money, founded by Bismarck in the 19th century, to care for the peoples health and keep them sane.

    The power of medicine is great and I don’t have much hope that they will recognize their jatrogenic injuries. For that they would have to understand what they are doing, not scientifically, but humanistically. Because the big question is whether every science is also humanistically justified.

    Twenty years ago, they burnt my esophagus during radiation therapy on my sternum. The burning is still visible on my skin today. Many doctors have seen this burning in the meantime and some have asked what it is, without any comment.
    What this profession is excellent at is keeping quiet, covering up and ignoring what they are not directly responsible for.
    They then diligently treated the consequences of this burning on the stomach and esophagus and also gave a diagnosis. I am writing this because these diagnoses give the impression that my body developed these symptoms itself. There is no reference to the burning. I have these symptoms, everything else is ignored. That is what I mean with humanity. I am a system with experinces, not a symptome. Body medicine is very close to psychiatry. Psychiatry is only openly aggressive and judging towards the patient, while the rest is covertly transferring responsibility from the doctor to the patient.
    I have learnt to take responsibility for myself, to treat my stomach by myself, to eat accordingly and to feel what is good for me. That is the only way to stay away from doctors. You can do so much by yourself for your health. Only my dentist will see me regulary, when she find an appointment ;-).

    Your article has further intensified my understanding of these connections.

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  6. I have been in hiding from the entire Health Care Industry for the past 7 years.
    I was harmed.

    Still, I’ve needed Cataract surgery and Teeth pulled. Anesthesia. What I’ve told these folks is: my Kidney Function is stage 3 (for drug clearance) and “a resting heart rate in the low 40’s is normal for me – check my oxygen saturation rate” (because I set off the monitors).

    I am not a medical professional. But, I would think that knowledge of those 2 physical health anomalies (outside of the study groups, that claim their treatments are safe and effective) would give the professionals enough information to NOT kill me, with their treatments?

    As I investigate what happened to me (way back when – a menopausal woman with a headache was diagnosed as having Bipolar Disorder) …
    I now think “they” didn’t know, and “they” didn’t know, that “they” didn’t know.

    Between of these 2 anomalies (kidneys and heart) – I believe, the complexity of treating my body, is beyond what science knows (or even has time to think about).

    Side effects of mind altering drugs were misdiagnosed as Bipolar Disorder (as well as normally occurring mood swings of menopause).

    I can’t say it aloud (they would claim I was paranoid), but I can’t believe “they” didn’t kill me! I came to this conclusion, and bet my future on “Mother “Nature”. I am still here, and loving life.

    Folks – for gosh sakes – know your kidney and liver function and if below normal … watch out for pharmaceuticals! Likewise, know your heart function. I’m older than 65, and cardiac risk of Anti Psychotics is well known to readers of MIA. It is not unreasonable for me, to imagine a stroke, or sudden cardiac death – from some health care professional, in my future.

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  7. I am a psychiatrist and training to be an analyst. I found this to be a very profound read. Ultimately, I also understand the argument that in this view, even “successful treatments” can be part of the larger Iatrogenesis. I do think that the arguments would be stronger and more welcome by a larger group of psychiatrists if the data were presented in a less skewed way— to say that placebo is more effective than antidepressants is disingenuous, not to mention things like stimulants and ECT which show very clear separation from placebo. The withdrawal symptoms from SSRIs are also mostly mild and short-lived even if there are some far more severe and chronic forms. I’m not advocating for those treatments per se, just saying that it provides a straw man that allows psychiatrists to dismiss the whole argument far too easily.

    But many of the things you write about, from the need to label, the decontextualization of pain and suffering and the absence of meaning-making are a big part of why I am pursuing psychoanalysis as a form of working with folks to understand themselves.

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    • These things are only “more effective” based on the very narrow definitions of “success” that are promoted by those favoring the drug paradigm. Stimulants, for instance, do have an effect of “reducing the core symptoms of ADHD,” aka making most kids less active, more focused, etc. However, looking at long-term outcomes, stimulants have never been shown to do anything to improve school outcomes, reduce delinquency, increase college admission, or even improve self esteem. It is misleading at best to say that “stimulants are effective” when they don’t actually improve the things people want to see improved for their children. These definitions of “success” limit us to looking at “symptom relief” and avoid looking at long term outcomes and also discourage looking for real solutions that last. It enables makers of antidepressants to claim that ADs are “just as effective” as quality therapy, because both reduce the “symptoms.” This obviously neglects that as soon as we stop the “antidepressants,” the “symptoms” tend to come back, often worse than ever, while effective therapy makes it possible to live with “less symptoms” over a longer period of time without ongoing “treatment.” How these can be called equivalent outcomes is beyond comprehension, but they get away with it by defining success “treating” these “disorders” by reducing their “symptoms” instead of by improving the quality of life for the client for the long term. It’s not accidental. It’s defined this way to ensure that the drug market remains lucrative and people don’t start demanding higher quality interventions.

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      • This is simply not true. Of course it is incredibly hard to find good quality long term studies that show causative relationships between medications and outcomes, however there are several studies that show improvements in social functioning, academic performance, peer relationships for kids on stimulants into adolescence and beyond. Not only that but it also significantly reduces the frequency of substance abuse and things like car accidents etc.

        I do not claim it to be a panacea. I myself am not on them even though I’ve been diagnosed with ADHD but that is in part due to significant stigma in my family of origin. I also think it is terrible that many psychiatrists would like to reduce ADHD to a biological thing that requires stimulants instead of understanding it in its socio-cultural context, as well as around attachment/trauma paradigms.

        I do want to mention that I read this magazine because I believe that our field is deeply flawed and want to remain connected to all that is anti-psychiatry so that I can keep learning. I am a therapy first psychiatrist, and 90% of my practice is therapy-only, with the remaining being combined treatments. I do not meet for less than 45 minutes at a time because I do not believe in quick med visits or reducing treatment to biology. I don’t believe in symptom reduction treatment. I think we probably agree on more than we disagree, though I have witnessed many times how some peoples’ lives truly change for the better with medications. I just don’t think these should be treated as one size fits all solutions.

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        • There are no long-term reviews of the literature showing improved long-term outcomes. This includes Barkley and Cunningham in 1978, Swanson in 1993, and the Oregon State Medication Effectiveness Study in 2002 or so. There are also observational studies, including the MTA 3, 6 and 9 year followups (there were some benefits at the one year mark), the Quebec study, the Raine study in Australia, and a comparative study between the USA and Finland done in the 2000s or so.

          I’m sure you can dig up some individual studies that will show an improvement in one area or another, but reviews look at a lot of studies over time, and they tell us whether or not individual studies are anomalous or what subgroups might benefit. Many comparisons have shown again and again that kids who take stimulants over time time don’t do any better than those who don’t. They don’t necessarily do worse, either (though both Raine and Quebec did show some negative outcomes), but of course, there are adverse effects, especially loss of height compared to the average. So if there are adverse effects and no clear and significant benefits, it’s not a good bet to use such an intervention broadly as stimulants have been used. Millions and millions of kids are taking these for years for very little overall benefit, notwithstanding some small reduction in car accidents. I think this should be known. Your assurance that “you are wrong” is of course as scientific as “I don’t want it to be true.” If you want to make a real argument, please show us some long-term studies that find a significant benefit for stimulant users over a long period of time (years). I’m always happy to look at studies. But making claims that there are long-term benefits without evidentiary backup won’t work for me.

          BTW, I have no doubt many people feel they benefit greatly from “symptom reduction,” and I don’t want to deny them any of these benefits. I just think we need to be honest in admitting that short-term behavioral improvement from the adult viewpoint does not necessary translate into long-term improvements in test scores or delinquency or college enrollment or mood or self-esteem measurements. People can’t make good decisions on bad information.

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          • I think you are right that there are few reviews showing long term benefits in the outcomes you are describing, however Shaw et al (2012) and Arnold et al (2020) address some of those. Powers et al (2008) and Barbaresi et al (2007) show improvements academically, reduced school absenteeism, grade retention, etc. Biederman et al (2009) and Rasmussen et al (2019) showed decreased rates of developing psychiatric comorbidities, rates of substance use, criminal behavior.

            I have not done any deep dives into these papers and so I’m sure they have limitations as do all scientific papers. But I also think you could be using psychiatry’s reliance on “Evidence Base” against it in that so much of what has been moved away from in mental health are therapies that are hard to study in Randomized control trials. Similarly, to show definitely that stimulants improve long term outcomes alone is an impossibly high standard given the huge number of variables that go into the measures you describe. What I ultimately agree with you on is that the psychopharmacologu industry tries to suggest that meds alone will do the trick, and shuts down exploration into all of the other aspects of these problems including a broken foster care system, severe trauma, our jail system, high rates of child abuse, substance abuse, etc etc.

            Anecdotally, from my practice, it can be night and day for a lot of people on stimulants who all of sudden are able to focus in class, connect with peers, participate more actively with less social anxiety, attend to important tasks that they otherwise miss or blow off. I mean the list goes on.

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        • “Of course it is incredibly hard to find good quality long term studies that show causative relationships between medications and outcomes ….”

          As a medically trained doctor, Omar, weren’t you taught about anticholinergic toxidrome in med school (like all other MDs)?

          https://en.wikipedia.org/wiki/Toxidrome

          What’s so difficult about garnering insight into the “causative relationships between medications and outcomes,” when you were likely taught about what drug classes cause anticholinergic toxidrome (and its insideous symptoms) in med school?

          Thank you, as always, Bruce, for your insightful articles. Please stop neurotoxic poisoning the children, et al, doctors.

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        • Hi Omar,
          I agree in general with what you are saying. I read Levine’s article and before I had even looked at any comments, raised my eyebrows at some of the claims and generalisations.
          I work as an advocate for mental health reform in Australia. I also have many years of personal lived experience with serious mental health problems (schizophrenia). In my opinion and experience there is plenty wrong with the current predominantly biomedical approach to mental health but there also seems to a big problem with the “black and white” thinking from both sides often making unsubstantiated claims that can only be dismissed as poor science.
          On a positive note I am coming across an increasing number of mental health professionals who are very well aware of the limitations of conservative “old school” thinking and are looking towards best practices.
          I think this progressive change to something much better still has a long way to go but those who are at least trying to embrace it should be applauded for doing so.

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      • https://pubmed.ncbi.nlm.nih.gov/11945110/

        This is just one study with a small N but it is fairly consistent across studies. Beyond that, in my ~7 years of experience, I have only had one patient who struggled with significant discontinuation symptoms and they resolved with a very slow taper. That’s not to negate the harms of the medications, the fact that some people do actually have horrible and prolonged discontinuation side effects/sexual side effects, or to deny that psychiatry has for far too long tried to reduce mental experience to biology in a way that is extremely harmful and problematic.

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        • “Beyond that, in my ~7 years of experience, I have only had one patient who struggled with significant discontinuation symptoms”

          In another comment, you state that you only prescribe drugs to 10% of patients. This is anecdotal.

          “I do think that the arguments would be stronger and more welcome by a larger group of psychiatrists if the data were presented in a less skewed way”

          This comment is so disturbing. Why do psychiatrists need to be presented with exactly the “right” (in their eyes) argument before they will even consider doing something about the wholesale destruction they/their profession causes as evidenced by Dr. Levine’s article, this website, the comments on this website, dozens of books and documentaries, websites like Surviving Antidepressants and Inner Compass Initiative, reddit subs like r/antipsychiatry, the comments on this article, and infinitely more evidence that Psychiatry is destroying lives.

          You would think a “helping” profession would want to hear this feedback and do something about it, not wait around for the argument that most perfectly pleases them.

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        • Omar, I think some humility on your part is called for. After all, the big wide world is quite a bit larger than your little practice.

          P.S. Perhaps you should spend time on websites run by people who are struggling with iatrogenic illness caused by psychiatric drugs.

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          • I’m not claiming otherwise. I’ve even mentioned that my practice is small, and not largely medication focused. And I agree I should read about iatrogenic disease. That’s after all why I read these articles. I believe people who have had severe side effects from medications of course, but I do not think the people who run those websites are more correct than people who describe tremendous benefits from medications. It’s easy to find the perspective one already subscribes to if you look hard enough online.

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          • “I believe people who have had severe side effects from medications of course, but I do not think the people who run those websites are more correct than people who describe tremendous benefits from medications.”
             
            It sounds to me as though you already subscribe to the idea that the benefits of psychiatric “medications” outweigh the risk of developing debilitating side effects or a life-altering protracted withdrawal which in the face of the ever-increasing number of people experiencing such easily avoidable drug-induced calamities proves that these risks are not only all too real but all too frequent.

            The fact is no matter what perspective you subscribe to, psychiatric “medications” pose serious risks that are unnecessary and therefore unjustified yet much of the time are downplayed or even ignored by physicians, which for the sake of common sense begs the question: Why take unnecessary chances with people’s health when studies exist that show the passage of time is often enough all it takes for difficult feelings to resolve or subside?

            Seven years of practice is a drop in the bucket for the simple reason that iatrogenic illness can often take much longer to develop, especially if someone is attempting to decrease or stop psychiatric “medication”. And if you doubt that statement, I suggest that instead of searching for statistics that support your beliefs you spend more time reading MIA’s Personal Stories for a glimpse of what people actually go through.

            P.S. If given enough time, wisdom will tell you that emotional healing takes time, not psychiatric “medications”.

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        • I don’t think much of doctors who don’t understand the wisdom of patience, who don’t mind playing Russian Roulette with people’s health, who pay more attention to the often-dubious studies than to the actual people whose lives have been ruined thanks to what he calls “medications”.

          It seems to me Omar has yet to learn the consequences of taking unnecessary chances.

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          • I feel that you are taking my words out of context or misconstruing them. The practice of psychoanalytic psychotherapies for example, include therapies that can last for years, even decades, meeting sometimes up to 4-5x/week in which the main goal is to create space for people to find meaning in their lives, become less fearful of their own minds and to understand themselves more deeply, all while aiming for neutrality (not assuming one knows best for their patients/clients). That is what I am dedicating my career to because I find that helping people know themselves and fear themselves less is liberating for them, and deeply rewarding as a provider. I believe that to be a form of patience.

            All that said, you state that I have already subscribed to the idea that benefits outweigh the risks of prescribing medications, though that assumes there is a one-size fits all risk assessment. I think that for some patients the benefits outweigh the risks, however it sounds like you subscribe to the idea that the risks outweigh the benefits.

            You then state that doctors do not have the studies to back these claims of benefits, and say that my 7 years is a drop in the mud (while not considering that I have seen 1000s of patients in more acute settings and learned from hundreds of psychiatrists and therapists with their own decades long practices, as well as learning from peer advisors and more, attended HVN meetings and more). Essentially you state that any anecdotal evidence that psychiatrists might use are not really helpful, but then you want me to rely on peoples’ testimonials of negative outcomes (i.e. anecdotal evidence) and use those as clear and convincing evidence against the use of medications, period. When I read that, it makes me feel that you discredit the experiences of the millions of people world wide who themselves feel the benefits of medications and like taking them as if they have been duped/hypnotized/made to drink the Koolaid, or as if they have achieved some cheap/morally inferior form of relief.

            I think I probably have more in common with the folks reading this magazine as comes across, and it’s sad how it is easy to feel so polarized across power-differentials. My main feeling is that I don’t believe in a one-size fits all model, I don’t think that medications are always the answer but don’t think they are never the answer either.

            I think this country has a lot to work on in terms of coercive prescriptive practices, education for psychiatrists that makes more clear the harms of medications and deemphasizes a purely medical model/biological model of mental illness and creatively and collaboratively developing spaces in which people who are not doing well and pose a risk of harm to self or others, who do not want treatment, can be safe and placed in spaces better than what we have now (hospitals can be horrific, and can iatrogenically make violence worse, without a doubt), developing stronger community programs with more peer involvement. I hope to continue to advocate for these changes as best I can and that we can come to see we are not actually on opposite sides.

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        • Omar, I do believe that the risks of psychiatric medications outweigh the benefits for most, but not all, considering the casualness with which these substances are routinely prescribed today. And yes, I also think that people who don’t have financial or professional skin in the game have much more to say than those who do because routinely most of those who do are foolish enough to think their position doesn’t influence their decisions, a fact that is proved, I think, by your defensive reaction to my statements borne of lived experience.

          And one more thing: iatrogenic illnesses caused by psychiatric drugs are among the most debilitating conditions known to humans, a tragic situation made all the more treacherous because the cause, namely psychiatric drugs, has long been identified yet are routinely ignored and, most tragic of all, almost impossible to “treat”.

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          • I appreciate everyone that’s taken the time out of their days to challenge me and share their views. To your last point, I think of Tardive syndromes but was wondering if you had others in mind so I can read up more on them. Lastly, for you or anyone else reading this, are there resources out there for alternative approaches to things like what we call mania or psychosis or severe depression that exist outside the medical model (or since some here have been critical of psychotherapies too, outside of psychotherapy). If you don’t have time, I also understand. I think I’m going to disconnect at this point.

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          • …and Omar, psychiatric drugs aren’t the only culprit as the same goes often enough for the significantly negative impacts on people’s brains from electro-convulsive therapy, not to mention the often-lifelong emotional damage caused by overconfident “psychotherapists”.

            IMHO.

            P.S. It might be wise to consider that negative outcomes whether from psychiatric drugs, ETC and/or psychotherapy are very probably not taken seriously or very possibly not reported at all.

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          • Omar, I appreciate that you take seriously the reality of iatrogenic harm done by psychiatric drugs. I think the fact that you’re looking for information speaks to how poorly informed most psychiatrists are regarding the matter.

            I strongly suggest you look into akathisia as this can be just as unendurable (if not more so) than tardive dyskinesia/dystonia. And I should know as I lived through all three for over six years.

            And as for alternative approaches to things like what we call mania or psychosis or severe depression, you might try reading today’s Personal Story called “My Story of Surviving Psychiatry” from Mad in the UK. It’s a remarkably vivid testimony of what I think most people in emotional crisis most often truly need when in emotional crisis.

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          • Thank you for all the recommendations. I’ll save them and get to them as I can!

            As a side note, I find one challenging thing about this whole discussion/debate is that it can feel very experience distance because the conversation is around statistics and varying measures of statistical significance in studies. One of the issues in the system is how psychiatrists are used. For example, I have a patient who was left by her husband 2 weeks after their child was born. Understandably she became severely depressed and anxious. She had been seeing a therapist for 15 years when she came to me and it was 2 years later. She remained down and anxious and was so anxious that she would not let her daughter out of her sight. It was starting to cause legal problems for her, her kid was beginning to show signs of aggression towards other kids and was herself having intense separation anxiety. She was having panic attacks every night and having trouble working because of concerns for her child’s safety and this was negatively impacting her self esteem.

            I hear this story and of course am able to say that to label her as having MDD and GAD is completely reductionistic and misses the point that anyone would be distraught in her position. I ended up starting her on Zoloft and increased her dose to therapeutic dose. While she remained sad and anxious she felt less stuck on her thoughts about her child’s safety and was able to put her in daycare a few days a week while getting a part time job which improved her self esteem. 2 years later we decided together it was worth coming off the medication since she had been doing well and she and I had established a strong relationship, and because she had gained some weight on the medication. She came off over a period of 4-5 months and is now off all medications for a few months, doing very well.

            So my question is, for someone like this who is having a lot of symptoms that are affecting their child’s mental health and that is causing them to feel totally trapped in their lives, how would anti-psychiatry folks approach someone like this?

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        • Omar, if you happen to get bored with my previous suggestions, I highly recommend the following videos from Daniel Mackler:

          1. “How to Be a Psychiatrist”
          2. “The Psych Med Song”
          3. “Little Bottles”
          4. “Bullshit”
          5. “I Don’t Want Your Diagnoses”

          All can be found in his Anti-Psychiatry Playlist on YouTube

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    • To Omar:
      You have made a number of sweeping, unsubstantiated claims that bear closer examination.
      Without the dubious authority of the ever-changing, pseudo-scientific categories of the DSM compendium of billing codes, precisely what endows psychoanalysts (or any other so-called mental heath practitioner, for that matter) with the superior knowledge, insight, and wisdom enabling them to help people in various states of emotional crisis or distress to “understand themselves?” On what credible basis should all the gurus who presumptuously pose as experts on human emotion and behavior (Freud, Jung, Janov, Ellis, Reich, Lowen, Skinner, Hubbard, Kramer, Lieberman, Beck, etc. etc.) be credited with such curative powers? What is it they offer that cannot be provided by a non-hierarchical, non-judgmental support group of intelligent, empathetic peers? A would-be medical profession that lacks universally applicable, verifiable criteria for assessing the efficacy of its “treatments” is essentially nothing more than a mercenary cult or racket.

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    • Psychiatry is quite successful in destabilizing “patients” and causing the trajectory of the patient to go nowhere or a one way ticket- leading to the “patient for life” syndrome with endless treatments and constant adjustments.

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  8. I’m a psychiatric survivor who lives with damaged kidneys from lithium and weight gain from Zyprexa. I’ve managed to remain married and have chartered a career as an educator. I spent most of my career in the field of at-risk youth. It strikes me that these youth are greatly exposed to psychiatric treatments and are exposed to a high level of prescribed psychiatric drugs.
    I won the nomination for Congress in the southern district of West Virginia. Just recently, Paris Hilton testified before the Senate about the problematic troubled teen industry. The testimony did shade into the discussion of forced druggings to manage behavior in these facilities. It is my feeling that we need Congressional hearings to educate the public about this serious problem. I’m also a harsh critic of the bipartisan foreign policy establishment.

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    • There is no hope for a politician, even one under the illusion that they are helping to create the problems through the very means that the problems were created in the first place. Wealth and social status would obviously be a proxy for spiritual karma in a world destroyed by this very power and greed. But there is a different kind of power in seeing all this clearly and honestly. I would recommend it to anybody but those in gratifying professions or satisfying social positions will be the last to open their eyes.

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  10. Thanks, Dr. Levine.
    I’m ‘textbook’.
    15 years of the ‘usual’ polypharmacy for “lifelong” BD 1, diagnosed following insomnia caused by money worries…. resulted in damages.
    Some examples were 2 NMS-ADR’s, cardiomyopathy, akathesia & a prefrontal focal lesion. The addiction(s) to benzos, antipsychotics and anticonvulsants prescribed for over a decade every 24 hours are validated by a dr-guided 2.5 year withdrawal…with the paperwork. No one has EVER asked to see it. They prefer treating me as if I’m slightly delusional…but old, so who cares?

    The social and cultural iatrogenic damages were side-effects leading to bankruptcy #1, homelessness after losing my dream home of 12 years, and 3 years of post-withdrawal seizures leading to bankruptcy #2. (2004-2019)

    So why aren’t ANY of my doctors the slightest bit interested in THAT documented medical history?
    A 15-YEAR ADDICTION?
    AND THE RECORDS OF IATROGENIC DAMAGES?

    For my protection, I’ve listed and printed my entire psych-drug history, all the ADR’s, and labeled the list in ALL CAPS-“ALLERGIES” bold-type and underlined.
    AND insured the ANAPHYLAXIS caused by sloppy prescribing was featured. (I’ve seen their eyes light up like deers’-in-headlights when they see that in RED.)
    I added a 2 paragraph synopsis of the false diagnosis and vacation of it…and the DOCTOR-guided withdrawal from addiction.

    I INSISTED my primary enter it in my permanent medical record. It’s in the electronic portal for all service providers to reference in the future.

    “ALLERGIES” will give me a shot at preventing any additional psychotropic prescribing (fear of fatal ADR) should someone feel ‘uncomfortable’ and compelled to sedate me.

    It’s also a veiled warning shot…”Don’t even THINK about a psychiatric diagnostic ‘response’ OR ‘treatment’…in ANY situation.

    Having it on the record illustrates my comfort addressing the past MEDICAL ‘elephants’ in my history and my lack of hesitancy in openly discussing a false, incorrect diagnosis and the price I continue to pay.

    They respond as if I’m farting in (their) church.

    IF THESE HAD BEEN ‘STREET DRUGS’, IT WOULD BE THE FIRST ‘RED FLAG OF COMPLICATIONS AND CONSIDERATION OF MY MEDICAL HISTORY’….for any treatment possibility.
    THERE WOULD BE DISCUSSIONS, QUESTIONS, DETAILED HISTORY TAKEN.

    Knowing I pushed back effectively (to a doctor!!!..in a specialty!!!!) brands me as potentially litigious..in the future. The past 8 years have been consistent regarding their view.

    When I gave my primary ‘the list’ with a brief, practiced explanation of this complex danger in my history and safety & trust concerns…he wrote in his appointment notes, I had taken too much time and “…clearly didn’t respect personal boundaries”.

    THAT was his take-away. Not the complex, important medical issues.
    And he’s the ‘best’ of four I have moved to and from in the past 5 years.

    I’m on my own. Still.

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    • It is really difficult to deal with the mainstream medical community, who seems to be totally in bed with psychiatry’s iatrogenesis for profit, and nefarious reasons (at least in my case, and seemingly systemically) … once one’s already dealt with psychiatric iatrogenesis.

      I think they call it “the white wall of silence.”

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  11. Someone Else,
    During the years of my withdrawal, there were some harrowing brain moments. My ‘exit’ doctor tended to dismiss ALL of it as ‘anxiety’ (as in ‘THIS is what you ‘asked’ for’).

    I knew if I insisted it was far more debilitating and wanted more attention paid, it would chart poorly regarding the goal, the bigger picture-‘smooth’ sailing out the door, towards the rest of my life, safe from the drugs & people like him.

    I checked into ER’s when I couldn’t compose myself.

    I lived alone, friends had long ago walked away. I feared a heart attack, too much irony after fighting so hard to rescue myself.

    They usually occurred on the way to ANY medical appointment…(go figure!)..dental, mammo, lab reviews, counseling-in parking lots, waiting rooms, IN appointments…spinning into panic attacks and seizure-like ‘events’. Messy. And doctors didn’t like it. Their schedules were disrupted.

    It was in the ER’s, being attended by young, new doctors doing their required rotations thru emergency medicine, that I met extremely (quiet) sympathetic minds regarding the psych drugs damages and withdrawals.

    It was galvanizing. I had NEVER heard ANY medical pro express such ‘radical, treasonous’ thoughts…acknowledging and VALIDATING what they were seeing and hearing.

    One called me at home the next day, checking up on me with the number of a psychiatrist he liked. Another closed the door, pulled up a chair, and asked ALL the right questions about my road out…and how it started. He allowed me to prescribe for myself…2 lowest dosage Valium, to cut in quarters, and take, if needed that weekend…a security blanket. (THAT was the ONLY dosage I could tolerate.) It would calm my poor brain, calm my heart from racing.

    I never had to take them.

    They believed me. They were sympathetic. They wanted to mitigate my state of suffering.
    It was very moving….after 12 years of gaslighting.
    This was 2015-2016.

    I hoped they were the future.

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    • Glad you escaped the insanity of today’s psychiatric “system,” Krista. And I will say, upon my second reading of Bruce’s blog, he really did nail the nefarious nature of the DSM “bible” billing “system.”

      And I will say, when trying to help a loved one who was very “psychotic,” I did run into a young hospital psychiatrist – who actually confessed that he too, was a critical psychiatrist. I personally found the trick to getting respect from doctors, to be pointing out the medically known issue of anticholinergic toxidrome.

      https://en.wikipedia.org/wiki/Toxidrome

      Since both the antidepressants and antipsychotics are anticholinergic drugs … medically known to create “psychosis.” And all doctors are taught about anticholinergic toxidrome in med school.

      So keep the faith, maintain your hope, since I think more of the younger psychiatrists are wising up … if nothing else, out of being confronted with the medical reality of the iatrogenic harm, mainstream psychiatry as a whole, is systemically committing.

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      • I believe then and now that LIABILITY concerns trump all other issues.

        I had also practiced a carefully delivered speech, using precisely edited terms, requesting a safe place to be monitored…as a result of the past Geodon-created Cardiomyopathy….in their electronic record-sharing base.

        I could see them un-clench as I gave them a reason NOT to deal directly with the psychotropic problems…but one they could ‘problem-solve’, CARDIO!, as they are trained to do.

        Some were more interested than others, but they ALL had to take the history down. I gave them the past cause, diagnosis, treatment, poor prognosis, and my (clear) resiliency.

        As it was in my electronic records just-the-way-I-described (no editorializing)…I gained instant
        credibility.
        It was like a game…to get to a safe place in case I seized & stroked or my heart finally stopped.

        I got ‘luckier’ with these tactics..by not emphasizing the medical causes. They were less defensive….more sympathetic…coming to THAT position (bad ‘other’ docs [!], they thought) on their own.

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  12. “They believed me.”

    Pretty simple stuff. This is what freed me. For me, it came from an “Aging Life Coach”. She also, had experienced via a loved one – the hubris of health care professionals that mistakenly believed they knew what was best for another (resulting in loss of liberty – involuntarily incarceration, no crime committed).

    People are not animals (or babies). We have language. We can tell you when we are hurting, and what is hurting. I wouldn’t know how to measure the trade offs, but how many people actually had no awareness of what was right for them or not … versus how many people were telling (or screaming) don’t do that to me!

    This entire thread has been hijacked by a debate led by one individual (who represents a group that has harmed many who read here … harm – perhaps not intentionally). People have been harmed! It “is called iatrogenesis”.

    I am caring for a kitten with a broken leg. She cannot tell me. I can only observe her behavior (and cries of pain). I can’t make her lay still and heal. I must sedate her. It’s the only way. Worse – the sedating drug is one that harmed me! What a gift toward understanding the trade offs. She’s mostly fine, now and I am weaning her off the pharmaceutical.

    Or … my friend, now 91 – broke a vertebrae … again. She refused the concrete treatment (this is how she described it). Insurance refused rehab care. She was discharged to home, after 2 weeks. She could not move between chair and toilet. Apparently, this was someone else’s responsibility? Or the insurance company was playing the odds. Likely this woman would be dead, before anyone held the insurance company to account.

    That is how this thread reads to me. Perhaps a larger percentage of people believe psychoactive drugs help them, versus the number of people with real physical issues – caused by adverse effects. Are the health care professionals playing the odds?

    Krista – as I face aging alone (there’s millions of us, that do) … I’m with you! How do I keep these “do gooders” from harming me. They don’t know everything. They don’t even have time to know everything. They have overwhelming been wrong about my body.

    Quoted from the National Kidney Foundation”:
    Designing appropriate medication regimens in patients with kidney disease is a complex and dynamic process, and recent cross-sectional studies have highlighted the high incidence of inappropriate prescribing.

    If the pharmaceutical doesn’t clear my body (CKD stage 3 – stable), then repeated doses are effectively poisoning me. “They” don’t know enough.

    It “is called iatrogenesis”.
    My mistake was I thought “they” knew what “they” were doing. “They” don’t. “They” only know the knowledge of their times. Perhaps 100 years from now?

    Pharmaceuticals are not tested on bodies like mine. Beware. Informed consent.

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  13. Look at all of the hard work being done by people (psychiatric survivors, researchers, journalists, whistleblower psychiatrists, loved ones of those lost to psychiatry…) to show the harm psychiatry causes, while the profession that’s causing the harm sits back with their arms folded and says “Prove it. Prove that we’re destroying lives. You haven’t proved anything to me.”. And yet it was so easy for them to be convinced to write millions of prescriptions to “correct” an imaginary chemical imbalance in their patients’ brains. Could this have anything to do with money?

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  14. To Omar,

    As to your statement:
    “I think I probably have more in common with the folks reading this magazine as comes across, and it’s sad how it is easy to feel so polarized across power-differentials.”

    What does this mean? Why is it relevant? Do you believe that because you’re in the majority (“I have more in common”) that your opinion should be given more weight? If in fact it’s true that you “have more in common…” do you think that we who object to psychiatry are outliers and should be ignored or discredited?

    Interesting that you mention “power differentials”. Maybe you’re not used to environments where psychiatric survivors’ comments are not banned. There are very few places where those of us who were harmed and made ill by psychiatry get to have a voice. This is one of them.

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  15. To Omar:
    Again, you have made certain claims but failed to provide the precise data that would convincingly substantiate them.
    Your assertion that “millions of people worldwide” benefit from psychiatric medications and enjoy taking them of their own volition, without being duped by various authority figures, immediately raises two questions.
    I would first like to ask, can you cite the exact percentage of those clients whose lives have supposedly been improved in some way by undergoing chemical lobotomies, electroshock, or whatever the latest fad in mental health “therapy” may be, as contrasted to victims who have been harmed physically and/or scarred emotionally as a result of such treatments?
    Second, I find it quite remarkable that you assume the countless number of psychiatric patients throughout the world who ingest potent neurotoxins, sometimes for decades, seemingly do so on the basis of sound research findings and with full awareness of frequent severe side effects. Is this in fact the case? How many of these people have been misled to believe that they suffer from an incurable chemical imbalance or faulty brain circuitry by Big Pharma advertising or by professionals with serious conflicts of interest (e.g. over 60% of the DSM panel members profit financially from their connection with drug companies). Are all the parents who willingly allow their children to be slowly poisoned with Ritalin and other cocaine-like stimulants to remedy a purely hypothetical disorder being told the whole truth about the long-term deleterious effects of such supposed therapy?

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  16. If you show me data about the frequent severe side effects, or the “whole truth” about the deleterious effects of Ritalin, I will spend some time looking for articles with data that meets your definition of sound. But one of the basic measures in research is number needed to treat and number needed to harm. These are generally factored into any decision for a medication to make it to market and to become something commonly prescribed.

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  17. Psychiatry is a business and it is often referred to as an “industry” by its practitioners. Where failure is success! Founded (along with psychologists) by fraudsters and con artists it mirrors the failure of US foreign policy abroad for the last few decades- ignore its failures and redefine it as major successes.

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  19. My comment from Aug 5 still awaiting moderation.

    History has shown it is extremely dangerous to prescribe psych drugs to a young mother who is under stress. In this society we don’t support mothers. We just stand by and judge them. Maybe that should change. I was abandoned by family and my child’s father, homeless and pregnant and because of my so-called psychiatry history I was kicked out of a home run by the church for pregnant women. I spent the last 5 months of my pregnancy and a locked psych ward. Psychiatry is the worst thing for mothers. I was discharged to homelessness, my son taken and put into foster care.

    Why would a single mother need to be medicated when obviously the lack of social support is the problem. Do psychiatrists not understand what life is like for the single mother of an infant? It seems like they have no clue if drugs are the only solution.

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  20. A child “beginning to show signs of aggression toward other children” is like any other child. If a child never showed signs of aggression toward other children, that would be extremely unusual.

    Omar, it sounds like you’re trying to convince people that the only solution for this stressed out single mother was to put her on drugs. (Did she fall into the 10% of patients that you use drugs with?)

    I wonder if psychiatrists think our society is perfect and that nothing needs to change. Do you believe, Omar, that mothers, and single mothers in particular, receive enough support in our society? Do you think that single mothers face too much judgment? Have you been on social media? If you were the single parent of an infant, would you want a professional to decide that the only thing that is going to help you is drugs? Don’t you think you might want to have some social support? Was this woman in a safe housing situation? Did she have someone to help her with child care? Was she strapped for money? Did the child have a safe place to play outdoors? Were either of them facing issues with their physical health? Were the mother’s parents/siblings in the picture? If so, did they alleviate or add to the woman’s stress. My family made me feel like a failure as a mother and as a human being every chance they got). I was put on so many drugs when I needed people to stop shaming me every second for being a single mother.

    I don’t understand this at all. I don’t understand and I will never understand how psychiatrists come to these conclusions that are so far removed from what I see as reality and yet society applauds them and pays them and nothing will ever change. But more lives will be ruined.

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    • Hi Kate, I really do appreciate your messages, even if I disagree at times with what you’re saying. In this case, I certainly did not believe that medicating the patient was the solution to all of her problems, nor did I think that her issues could be best described as being about her neurotransmitters or about her biology. I was well aware of the many many pressures she was facing and the devastation of new motherhood all alone. However, she was estranged from her family, and had limited social supports. Not only this but she had panic symptoms when leaving her home and so her ability to connect with others to help was limited. She came to me asking for help to reduce her symptoms to help her address the many things in her life she wanted to take care of to get back on her feet. I saw her in 45 minute visits where we talked about what it meant for her to be with her daughter and the special connection they had, and how it differed from her relationship with her own mother. We talked about her anger at her partner who abandoned her and her feeling of being abandoned by her daughter when she left her womb. I saw the role of medications as a scaffolding to help her engage in the therapy more effectively and to help her recruit more social supports.

      She in fact got on her feet, her anxiety improved considerably in about 4-6 weeks (despite 2 years of depression before then). She felt that even when she felt anxious she didn’t feel like she would fall apart, and now after 2 years of work together, she’s off all medications, in a new relationship and working. In no way shape or form do I believe that meds are the whole story, or even most of it. But I think the medications were like a cast or crutches that someone wears while they nurse their injury back to health. The work of strengthening the muscles again through “PT” was arguably more important but the cast was important to her recovery.

      If her circumstances had been different and she had more access to social supports, or if she had more financial stability, I would have agreed with you all here and likely deferred on starting medications and tried to brainstorm with her ways of having building up her sense of belonging and decreasing her shame. We live in a very imperfect society and I practice psychiatry knowing that many things that ail us individually are rooted in social forces that have been around for centuries or longer, so if I can help even a little with meds because changing the social landscape is less in my control and less likely to change in time for the patient’s darkest moments, I will.

      To Birdsong, one thing that hamstrung my thinking of different options is that she had been working with a therapist for 15 years and there are politics of not stepping on the toes of your colleague when doing split treatment. So my role is to “stay in my lane” which is why I hate doing split treatments. So based on what the therapist had told me, she had tried many different approaches to help and none had. Not the best answer, nor the one I’m most proud of, but it’s the truth.

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  21. “As a side note, I find one challenging thing about this whole discussion/debate is that it can feel very experience distance because the conversation is around statistics and varying measures of statistical significance in studies”

    Maybe because when ex-patients share their experience with psychiatry and how it destroyed their lives, the “experts” shout us down with “that’s anecdotal, it doesn’t count, that’s your subjective experience, it’s not trustworthy, you’re an outlier, you’re mentally ill, you don’t know anything about how science works” etc.

    Maybe psychiatrists should drop the facade of “I’m open to hearing from you antipsychiatry folks, but you’re going to half to work a little harder to convince me” and admit that they are never going to change their views or dis the pharma machine that’s buttered their bread all of these years. The truth is, just like psychiatrists, we don’t have to prove anything. Look how far psychiatry has gotten while they haven’t ever proved the validity of even one of their hundreds of diagnoses.

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    • you’re right that I’m not ready to get rid of pharmacology as part of my toolset in treating folks with mental illness, but being on these websites and hearing from peoples’ lived experiences helps me better appreciate how medications affect some people who don’t often get as much of a voice and also to learn about alternate approaches, which is why I appreciated so much birdsong sending me those episodes.

      I also thank you for sharing your experience with me when you didn’t have to. I am grateful to you for letting me into some of your pain and anger towards the field. It helps me tap into my own as well.

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      • Inasmuch as so-called emotional disorders do not exist except as metaphors for certain socially proscribed thoughts or behaviors (and those metaphors are invented or abandoned over the course of time in accordance with evolving societal trends, as one can clearly see in the case of the mythical drapetomania or the sudden declassification of homosexuality and transgenderism as mental illness), there can be no genuine medical “treatment” for them in the absence of verifiable (NOT hypothetical) brain pathology. Thus your improper use of the euphemism “medications” instead of the more appropriate term “neurotoxins,” for example, perfectly illustrates the pernicious, self-serving fallacies of the mental health industry, which vainly attempts through specious arguments, concealment of contrary findings, and outright lies to justify its status as a legitimate, full-fledged branch of medicine. This vile “science of lies” (to use Thomas Szasz’s apt description) persists only because a vast worldwide network comprised of pharmaceutical companies, ECT device manufacturers, and venal enablers in academia, the media, and toothless regulatory agencies continues to reap obscene profits.

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          • YES! Well said. I do give Omar some credit for being inquisitive. I’ve heard that the questions we ask “drive” our thinking.
            The best decisions are well thought out informed decisions. (only if the information you’re working with is credible-trustworthy-accurate)

            “It pays to keep an open mind, but not so open your brains fall out.” I appreciate this discussion. I also appreciate the fact that MIA discussions/comments are “moderated.”

            How many people, these days, have conscientiously learned how to ascertain the difference between “fact and fake?”

            The DSM has been called a “fraudulent and illegitimate document.”

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        • I think for the most part I’ve maintained a respectful tone in my posts and have been making a good faith effort to engage here. In the case of your message however, I will have to respectfully, or maybe disrespectfully disagree. You can hold onto your abstract notions of the socially constructed nature of let’s call it mental suffering if mental illness is too charged. I will continue to try to meet folks where they are and help ease their mental suffering to the best of my ability. When I see the person with severe inattention struggling to maintain her job and fearing financial ruin and mounting student debt if she’s unable to meet her demands, I will prescribe stimulants and offer help in considering executive functioning strategies to help her retain her job, and I will do so using medications that are well researched to reduce symptoms and improve outcomes as illustrated in the papers I cited earlier. If I see a patient grappling with suicidal ideation and a sense of hopelessness about the world, I will at the very least offer medications which have been proven to help people reduce their suicidality (despite a black box warning that was given in the absence of evidence for any increase in suicidal behavior). I won’t ever treat it as the end all be all or “cure” but I also won’t withhold treatment that can be a game changer (and has been shown to be so for many people in the extensive research done), while still paying close attention to the risk of side effects, which in the vast majority of instances can be mitigated or reversed with dose reduction or discontinuation of treatment.

          Many many psychiatrists have long been critical of DSM-V and none of my close colleagues follow it closely, but it feels to me that several individuals here have decided that the morally right thing for individuals to do is suffer and hope that time will heal, and that to seek analgesic relief (symptom reduction) is somehow the sign of a weak brainwashed mind.

          Despite a productive conversation with Birdsong, to equate medications with street drugs is as disingenuous as it gets given the decades-long research that has gone into psych meds, TMS and yes even the boogieman ECT which now with ultrabrief pulse mitigates cognitive side effects and with the procedures in place is painless and quick, and which I’ve seen with my own two eyes rescue people from severe catatonia where people will die without intervention or restore memory in depressed elderly patients with cognitive impairment secondary to depression.

          The field and its treatments are undoubtedly imperfect and the brain is too complex to fully understand, but to pretend it’s all social construction and that the meds are no different from street drugs is to ignore the people who have been helped tremendously by treatment, myself included, or the peer advocate I worked with that swore by her lithium. One of my supervisors used to say that if you thought everything was biological you were defending against social and psychological/trauma-based ideas of what is happening in an individual and if you thought everything was social/psychological you were defending against the fact that we do have a tangible biological brain and genetic predispositions/wiring/temperamental factors. I try my best to hold onto both ideas even as I lean social/psychological and abhor handwavy ideas about neurotransmitters. I’d love hear you tell people that have been helped by medications that they have been brainwashed and that all of this was social construction.

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          • You are denying Kirsch’s reviews of the literature clearly showing an increase in suicidal thinking when taking SSRIs? I am also not aware of ANY review suggesting that suicide rates are reduced by SSRI or other antidepressants? Lithium is the only drug I know of that has evidence supporting this possibility, and that has more recently been called into doubt.

            Your willingness to make claims unsupported by literature reviews makes it hard to take your comments as unbiased.

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          • despite a black box warning that was given in the absence of evidence for any increase in suicidal behavior)

            Is the FDA an antipsychiatry conspiracy theorist?

            It’s pointless having these conversations where psychiatrists start off with a position of openness to hearing about the grievous harms psychiatry causes only to double down on the notion that the ones who were harmed don’t know what they were talking about.

            I don’t have to prove to you or anyone else that what I experienced was institutionally sanctioned abuse over a period of decades that has left me severely ill, traumatized and disabled.

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          • Many many psychiatrists have long been critical of DSM-V and none of my close colleagues follow it closely, but it feels to me that several individuals here have decided that the morally right thing for individuals to do is suffer and hope that time will heal, and that to seek analgesic relief (symptom reduction) is somehow the sign of a weak brainwashed mind.”

            No one said anything of the kind. I specifically mentioned the importance of social support.

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          • “or restore memory in depressed elderly patients with cognitive impairment secondary to depression.”

            This is outlandish. Do you have any proof of this outrageous claim? I was disabled by what you facetiously call “, the Boogeyman” ECT 20 years ago and then immediately blamed for my “failure to respond” with the words” You have borderline personality disorder. That’s why the ECT didn’t work.”. Why didn’t that genius psychiatrist know what my diagnosis was before he did ECT? Why did he think I had treatment resistant depression? Only a psychiatrist can do a damaging procedure based on his misdiagnosis of the patient and then further destroy the patient’s life and everyone claps for him. This is disgusting and abusive behavior.

            I’ll excuse myself from this conversation and go back to reading about Aktion t4. I know I’m not crazy.

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          • Omar, please do not think I consider using psychiatric drugs morally wrong because I do not. I consider it a personal choice.

            But I do believe there needs to be a good faith effort on the part of prescribers to find out what’s going on in a person’s life before prescribing and perhaps order lab tests to determine if physical conditions might explain how they feel.

            I think it’s fair to say that psychiatric drugs are overprescribed and that informed consent is routinely ignored. And it’s often true that when people try lowering or discontinuing them the withdrawal effects are wrongly interpreted as a “relapse” or signs of another “mental illness”. And from what I’ve learned it seems fair to say that psychaitric drugs act similarly to illegal psychoactive substances.

            And time can heal, althought I ought to have included that this usually requires the prescence of easily accessible as well as affordable social/emotional supports.

            And although it may not sound like it, I very much apperciate your open-mindedness.

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          • You have consistently failed to answer one of the most crucial questions raised in this entire debate: What is the exact percentage of people worldwide whose emotional suffering was supposedly alleviated by chemical lobotomies, ECT, TCM, and sundry other “treatments,” as opposed to those psychiatric patients who have suffered severe, irreversible life-long effects, such as suicidal ideation, tardive dyskinesia, akathisia, memory loss, sexual dysfunction, etc.? The entire history of psychiatry illustrates the failure of one highly touted therapy after another. I refer you to the works of Peter Breggin, Thomas Szasz, Peter Gotzsche, Jeffrey Masson, Bruce E. Levine, and Robert Whitaker, among many others, if you need evidence of this.

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          • “and yes even the boogieman ECT which now with ultrabrief pulse mitigates cognitive side effects and with the procedures in place is painless and quick, and which I’ve seen with my own two eyes … restore memory in depressed elderly patients with cognitive impairment secondary to depression.”

            With my heart in my throat, at the danger, of growing old – I’m going to dish it right back. I hope you are sued, your license revoked, and you are run out of town. I plan on dying alone in my apartment and stinking up the hall (when my time comes, of course). I am not dependent on doctors or pharmaceuticals for my very breath of life. That was given to me.

            How about a tee shirt for all of us, which reads “ I was harmed by iatrogenesis” … as a counterpoint, for making us wear our scarlet letters of “mentally ill” in those great big fancy electronic health records?

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          • Posting as moderator:

            Your email does not seem to have worked, it bounced back as not existing. I need a functioning email to have continued posts be published. I edited this one and removed the parts violating our Guidelines, but I can’t continue to do that. Please get back to me with a functioning email – it is an official requirement to post at MIA.

            Thanks in advance.

            Steve McCrea, Moderator

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          • “fact that we do have a tangible biological brain and genetic predispositions/wiring/temperamental factors.”

            I don’t know what this means. It sounds like word soup, not a reason to prescribe drugs.

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          • “…love hear you tell people that have been helped by medications that they have been brainwashed and that all of this was social construction.”

            But it’s fine that you and they will try to shame and bully me into silence and you will deny the grievous life-destroying harm that I experienced under “psychiatric care.”

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          • Sorry, I don’t have the context here. What did I say? Most likely I was not referring to you, as I generally avoid referring to individuals and if I do so I make it quite clear. I don’t remember directing anything toward you recently. Can you remind me what I said?

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      • “folks with mental illness”. As I said, your profession has never shown that to be anything more than a social construct. Was the single mother of an infant that you prescribed drugs to mentally ill?

        A crutch is something you can observe the mechanism of and how it is supporting a person. Not true of psychiatric drugs. No one has any idea how a person will react to psych drugs. Many people have gotten suicidal. Many people have killed themselves or someone else.

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        • The terms “mental illness, mental wellness, antipsychotics, antidepressants” are “copy writing” terms, like “kleenex.” I take an “antipsychotic” but really it’s a major tranquilizer.
          An organization, ISEPP, categorized psych chemicals into 4 groups: tranquilizer and sedatives=downers. Stimulants=uppers. analgesics=pain relievers. And the new kid on the block=psychedelics, hippie drugs.

          I worked in advertising, sales, marketing, and promotions. Among the “New York Madison Ave. International Advertising Agencies, there’s a “gauge,” a “mantra” for measuring success: “It’s not creative unless it sells.” I’ll have to look up the definition of “social constructs.”

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  22. “Look how far psychiatry has gotten while they haven’t ever proved the validity of even one of their hundreds of diagnoses.”

    I find myself wondering how long it will take before for the rest of the world finally catches up to this fact.

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  25. Omar, Dr. Josef’s video channel features lots of people that have actually experienced or are still experiencing iatrogenic harm from psychiatric drugs.

    I strongly suggest you watch these as doing so might give you a better understanding of the struggles faced by people both physically and emotionally as well as the pain of having to deal with a medical system that does not take their problems seriously.

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  26. To Omar: you sound like someone responsible enough to carefully weigh the pros and cons of prescribing psychiatric drugs as well as able to understand the importance of not keeping people on them indefinitely whenever possible.

    I understand the politics and other constraints you work under as well as those that burden(ed) the woman under your care.

    But the grim reality is that most M.D.’s are NOT like you which is a tragedy in the making for possibly hundreds of thousands of people now and in the future.

    And though it’s wonderful knowing the woman you reference is now doing well this doesn’t erase the fact that a significant number of people aren’t as lucky as she thanks to the careless manner in which psychiatric drugs are currently prescribed nor is it any indication that she will not experience seriously adverse effects or protracted withdrawal from psychiatric drugs in the future.

    The takeaway: USE EXTREME CAUTION —

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  28. Omar, thank you for asking about alternatives to psychiatric drugs.

    There’s quite a few of them in the YouTube film by Daniel Mackler called “Coming Off Psych Drugs: A Meeting of the Minds”.

    Seeing this film almost eight years ago gave me the courage to stop ALL psych drugs. And this was after having taken them for 32 years. And not for a minute have I ever felt the need to resume them.

    I also highly recommend his book called “From Trauma to Enlightenment: Self-Therapy in Twelve Steps”.

    Reading this book was better than any so-called “psychotherapy”, and that’s for sure.

    Be sure to catch the following video: “Is My Therapist Good or Not”. Seeing this validated all my frustrations regarding “psychotherapy” to the point I was able to quit the whole damn thing.

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    • CLARIFICATION: “Is My Therapist Good or Not? 12 Questions a Former Psychotherapist Asks”, from Daniel Mackler on YouTube.

      His vast video collection includes other films and videos that feature other mental health professionals who share his views on the use of psychiatric drugs.

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  29. https://www.madinamerica.com/2022/05/shady-world-shock-treatment/

    ECT is no joke, and I would say that calling this “procedure” “the Boogeyman” when millions have been left disabled, impaired and traumatized by it is pretty disrespectful. If you want real stories, Omar, and not “distanced” studies, one only needs to use Google to find a tribe of horror stories about ECT. I found the book “Doctors of Deception” extremely informative. The reddit antipsychiatry sub is full of stories of harm. I only wish I’d found these resources prior to “consenting” to ECT after the psychiatrist assured me that he’d never had a patient who experienced cognitive impairment or memory loss as a result of ECT (and he was the chief ECT Dr at the ivy league teaching hospital where this was done) and that I was a good candidate for ECT since, he told me, I had “treatment resistant depression” because I “hadn’t responded” to 6 years of prescribed drugs under the care of an outpatient psychiatrist who, as it turned out, kept NO records. Both of these psychiatrists thought it was no big deal that there were no records, and my “inappropriate anger” at learning that this psychiatrist had kept no records was one of the “symptoms” they uncovered that led to the borderline diagnosis (unfortunately for me, the ECT psychiatrist arrived at the borderline diagnosis only after the 6 or 8 or however many ECT treatments.). That plus my “failure to respond” to ECT really sealed my fate. I was also experiencing severe iron deficiency anemia and cold turkey Klonopin withdrawal while all of this was happening, but neither of these things were acknowledged. Guess that wasn’t important.

    I’ll never forget the psychiatrist’s “kindness” when he told me in my first appointment at his outpatient office after the ECT ended, “you have borderline personality disorder. That’s why the ECT didn’t work. You need dialectical behavior therapy.”. There were so many new words in that sentence, words I really would have liked to know the meaning of, but I could tell by the expression on the good doctor’s face that he was not open to further conversation and he quickly ended the appointment. I went home, where I lived alone and had no support system, and I looked up the words borderline personality disorder on the internet. The first thing that came up was character and Fatal Attraction who tries to murder everyone. I learned that that was a classic example of a borderline and that there was little hope for these people.

    If I come across as disrespectful, it may have something to do with the deeply disrespectful way I’ve been treated by the”helping professions”.

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    • Kate, I would not want to diminish or minimize your experience. It sounds horrible and unfair. One of my close friends and colleagues was diagnosed with BPD and died by suicide. I loved her tremendously and she made such a powerful impact on me and my career. So much of what drives me in education is to destigmatize personality, and to teach it from the perspective of trauma, and chronic invalidation. I can’t deny that I am extremely careful about diagnosing people with BPD in their chart because I don’t trust most psychiatrists to see it as more than a judgment, let alone the rest of medicine. I hope you have found some peace and good community to help through the medical trauma you have experienced, in addition to whatever preceded it. I will fully stop responding now but I appreciate your words.

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      • Thank you, but I need to tell you that I have no peace and no community thanks to Psychiatry and that diagnosis. The ECT followed by the BPD diagnosis was enough to destroy me, which I believe was the intention since they knew that I was trying to report the 6 years of no record keeping. I have no peace. I have no community. I can’t go to the doctor. I live in complete isolation. I have no life at all thanks to Psychiatry. Psychiatry hands out death sentences. So funny, because none of the diagnoses are even real. It’s all made up.

        And now Yale psychiatry that worked so hard to ruin my life and succeeded, they get million dollar grants from the government to “study ECT in dementia patients” while they send me threatening letters accusing me of fraud.

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      • I’m going to bet that your wonderful profession pushed her over the edge and caused her to commit suicide. No one has BPD. It’s a social construct made up by men. It isn’t real. She probably had severe trauma which was exacerbated by psychiatry.

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  30. Omar, something I think is very important is to never tell patients they may need psychiatric drugs for the rest of their life as this may not be true even for those experiencing psychotic or manic states. There’s always a chance these could be a once-in-a-lifetime experience and even if it isn’t, mindfulness and peer support are proving to be meaningful alternatives to pharmaceuticals.

    I know DSM diagnoses ease communication between professionals by providing rough outlines as to what people might be experiencing as well as facilitate dealing with insurance companies, but the fact is these can negatively impact people’s lives significantly in many ways.

    Again, I very much appreciate your open-mindedness regarding the clinical, social, and cultural harms of what Dr. Levine now most correctly refers to as IATROGENCIC PSYCHIATRY.

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    • I am having trouble keeping up with all the posts but I’ve appreciated so much of what you’ve said and think we have similar ideas about “good treatment.” I strongly believe that meds are way over prescribed and that a large bulk of psychiatrists are convinced of a very reductive biological view of mental health/illness which I find incredibly frustrated. Psychiatry was hurt by being embedded in medicine because there is such a chip on our shoulder that we need to be a “real science” which flattens some of the role of subjective experience in working with people, it’s horrible.

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      • I know it’s a lot, but I hope you find the time to listen VERY CAREFULLY to every video/podcast/film as each was chosen for a reason.

        I won’t be satisfied until psychiatry starts paying closer attention to ALL OF THE PEOPLE who’ve already been hurt and correcting its harmful diagnostic and prescribing practices.

        Thank you for engaging with me. It’s a pleasure knowing clinicians like you exist.

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  32. Harmed by pharmaceuticals,

    I am in a very similar situation. I avoid doctors at all costs, no matter how bad my physical ailments are (Most of these were caused by doctors, specifically psychiatrists, who thought right to heavily drug me for decades, as like an experiment I guess). I live in fear of some Good Samaritan helping person deciding that what I really need is more ECT or more for drugging because I am “suffering from mental illness” and need my power of self-determination stolen once again from me. Oh, they love to do ECT on sad old women, don’t they. I’d rather live in a tent than deal with more of this. The world is going to hell anyway.

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  33. “restore memory in depressed elderly patients with cognitive impairment secondary to depression.”

    How do people get to say things like this with no proof? Seizures caused by electricity to the brain which notoriously lead to memory loss and cognitive impairment now somehow restore memory in the vulnerable elderly? Well, it sounds like a very promising market $$$. Especially when the patient can’t say no.

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    • Not a blanket statement, but sometimes people with severe depression can develop cognitive symptoms and ECT improves their cognition by treating their depression. I think everyone accepts that ECT comes with real cognitive risks no doubt. This is a small sliver of patients I’m referring to.

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      • How would one know in advance who fits into this “sliver?” And with the attendant risks of severe congnitive symptoms DEVELOPING as a result of ECT, even in people who had none to start with, how can this possibly be consistent with a “first, do no harm” approach to medicine? Sounds more like Las Vegas “medicine” to me – “Come on, baby, give me a 7, give me a 7…”

        And no, “everyone” does not accept that ECT comes with “real cognitive risks,” based on my reading of the literature, in fact, the idea is denied or minimized chronically. Nor are patients almost ever informed of these cognitive risks even if the doctors do acknowledge them. You seem to have a very rosy view of how “informed consent” is handled in the “mental health” fields!

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        • That might be true. A cousin of mine was admitted to a standalone psych hospital and even with me trying my best to help him out throughout the process I was shocked at what I saw and at how hard it was to get any information.

          As for your first question, it’s not quite Las Vegas as much as it is thorough diagnostic evaluation for signs of cognitive impairment due to dementia vs something that emerged in the context of depression. Often times the depressed people that are referred to ECT, especially elderly are those who have stopped feeding themselves for example as a result of their depression. When I’ve seen improvements cognitively it is often something you can appreciate right away. When people start ECT in an ideal world there is a consenting process after each treatment, so you continue to assess if it’s helping or hurting along the way.

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          • So you only find out if it “works” after the fact. There is no evaluation that can predict the outcome of ECT, and I believe you know this is true. “Evaluations” in the “mental health” world rarely produce anything concrete that could be counted on to relate to predicted results. 30% of SSRI recipients improve in the short term (at best). How do we know which 30% will improve? We have no clue whatsoever. And that is typical.

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          • “That might be true.”

            “Might” be true??? IT IS TRUE the majority of the time. Comments like this reveal your bias towards biomedical methods.

            “In theory, there is no difference between theory and reality. In reality, there is.”

            Welcome to the real world, Omar.

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      • A small percentage of people who take heroin on a daily basis go on to live great lives, are productive and helpful to their communities, and great parents. It’s something about daily heroin use that really helps them achieve their highest potential.

        (Do I also get to post dangerous falsehoods here like “experts” do?)

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      • I just told you that the psychiatrist at Yale who did ECT on me and then blame me for the result does not accept that ECT comes with any kind of risk. So why don’t you track him down?

        This gaslighting bullshit from people with power and status explains why people who wind up in the system never get better. They are gaslit to death which is a form of torture.

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      • Small sliver was referring to the small portion of patients for whom ECT can have cognitive benefits. I was making the point that this is not meant to be taken as a general point.

        In terms of “might be true” I was referencing that it might be true that I have a rosy view of how psychiatry is practiced in different parts of the country.

        Not once have I denied that there are harmful outcomes. But I do disagree with the idea that these represent the majority of experiences. That does not detract from those stories or dismiss their importance. But it does suggest that just like you claim I have a rosy lens, those who have been negatively impacted are more likely to have a negative filter as well and dismiss positive outcomes. When I give informed consent, it is often from a risk-risk basis. There are risks to untreated illness too. Now there are two parts where we seem to be disagreeing on. The benefits of treatment (which in the case of ECT includes 80% remission of TRD) and 30% complete remission with SSRIs. And the frequency of severe or impairing adverse effects. There is no denying that many people have severe side effects that are underreported in the psychiatric literature, and that is horrible. But people here speak as if every person that takes a medication is at high risk of these effects, which is not the case. Lastly, the anti-psychiatry approach takes all medications as equally problematic even though some medications are significantly more toxic than others. That makes arguing challenging because I defend an SSRI and get criticized for ignoring side effects in antipsychotics or benzodiazepines. I don’t want to pretend to be the victim here but I do want to say that I have seen medications play a big role in people’s recovery and have seen negative outcomes too. The more we’re able to hold multiple perspectives, the better, in my opinion. I will continue to refine what I express are the risks in my risk-risk consent process, and will use what I learn here and the videos you recommended to challenge myself to deprescribe when I might otherwise take a “might as well keep the med on” approach.

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        • Again, I think you are playing fast and loose with the stats here. There is not a 30% complete remission with ADs. 30% beat out placebo by a significant margin. This does NOT suggest complete remission, in fact, a whole industry has developed around supplementary “AD” treatment for those with only “partial remission.” There is not a record of consistent benefit. 30% improving compared to placebo also means 70% do not. That’s a pretty crappy track record from any kind of treatment.

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        • “But people here speak as if every person who takes a medication is at high risk of these effects which is not the case at all.”

          Omar, generally you and I seem to agree on a lot. However, after reading this remark I find myself agreeing more with Steve than with you.

          Here’s two things very physician should learn:

          1. that low probability does not mean no probability
          2. there’s a difference between good medicine and defensive medicine

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        • “But I do disagree with the idea that these [harmful outcomes] represent the majority of experiences.”

          Omar, most of what you say is music to my ears. However, to me it doesn’t make any sense prescribing drugs for problems that with time might resolve on their own.

          Liability aside, I don’t think you fully grasp what risk-risk really means.

          P.S. I think you have a rosy view of psychiatry in general.

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        • You’re free to disagree with the idea that the majority of patients treated with psychiatric drugs do not experience adverse outcomes, but unless you can adduce credible studies to substantiate your belief, I will give more credence to reputable authors who assert the contrary, such as Peter Breggin, Phil Hickey, Bruce E. Levine, and Robert Whitaker, not to mention the many contributors to this website who suffer from the long-term effects of neurotoxins.

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  36. Please unsubscribe me from all mad in America articles. The constant gaslighting is pushing me past my breaking point. Bi already tried using the link and got an error message.

    I don’t know why you let people re-traumatize psych survivors all of the time.

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  41. Wiki: “Iatrogenesis is the causation of a disease, a harmful complication, or other ill effect by any medical activity, including diagnosis, intervention, error, or negligence.[1][2][3] First used in this sense in 1924,[1] the term was introduced to sociology in 1976 by Ivan Illich, alleging that industrialized societies impair quality of life by overmedicalizing life.[4] Iatrogenesis may thus include mental suffering via medical beliefs or a practitioner’s statements.[4][5][6] Some iatrogenic events are obvious, like amputation of the wrong limb, whereas others, like drug interactions, can evade recognition. In a 2013 estimate, about 20 million negative effects from treatment had occurred globally.[7] In 2013, an estimated 142,000 persons died from adverse effects of medical treatment, up from an estimated 94,000 in 1990.[8]”

    I am moving. I faced my fears, but an EHR is unyielding (as we know). So far, we can escape misdiagnosis via moving to another locale. The danger I am moving away from is a “Bipolar” diagnosis (dating from perimenopause – which was so long ago, I’m not sure that term was even in use, back then). I don’t blame anyone. It actually is story of scientific progress.

    It’s been seven years I have been in hiding. No symptoms, no meds, no healthcare encounters. But here was this EHR introducing me to everyone (X-ray techs, PT, etc as having this life threatening imaginary condition). I told them to “Stop it”. Immediately – healthcare went into defense mode. Their liability was more important than my misdiagnosis. Of course, I was not surprised.

    Why is this so dangerous? Take something simple, like an electrolyte imbalance – causing confusion. It’s the “imaginary gorilla” problem:
    https://www.npr.org/2010/05/19/126977945/bet-you-didnt-notice-the-invisible-gorilla

    If you are looking for mental illness, you might not see electrolyte imbalances, or pharmaceutical side effects (even if only a sliver, these things do happen and to those this happens too – their lives are every bit as important to them, as anyone else’s is)

    I am close on 70 years old. I want to live. I don’t have anymore patience (tolerance) for healthcare’s shenanigans. I am not a “population”. I am a human, and I cherish my life.

    I don’t understand how this comment thread was hijacked by a professional – everyone seems to want to argue with, or enlighten … or, I don’t get it? To a carpenter, everything looks like a nail.

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  42. I come to MIA to read the articles, but I relish the comment section.

    To all you brave souls who were so harmed by psychiatry and psychotherapy, yet still persistently come here to comment and make a difference for fellow survivors and those who are just awakening, my sincerest thanks. You make a difference, you really do.

    I wish I could have read such thoughts decades ago, and I am grateful for the opportunity to do so now.

    Don’t give up your passion- there will be many more who find their way to the comment section.

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